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Sagittal abdominal diameter: no advantage compared with other anthropometric measures as a correlate of components of the metabolic syndrome in elderly from the Hoorn Study^1,2,3

¹ From the Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije University Amsterdam, Amsterdam, Netherlands (JM-P, MBS, RMvD, and JCS); the Department of Endocrinology (RJH) and the EMGO Institute (MBS, JMD, LMB, RJH, GN, and JCS), Vrije University Medical Center, Amsterdam, Netherlands; the School of Physiology, Nutrition and Consumer Science, North-West University, Potchefstroom, South Africa (JMP); the Department of Nutrition, Harvard School of Public Health, Boston, MA, (RMVD); and the Department of Internal Medicine, Academic Hospital Maastricht, Maastricht, Netherlands (CDAS)

Background: The sagittal abdominal diameter has been proposed as a useful measure by which to estimate abdominal obesity and as being more strongly related to components of the metabolic syndrome than are other anthropometric measures.

Objective: The objective was to study which anthropometric measure (ie, sagittal abdominal diameter, waist circumference, waist-to-hip ratio, waist-to-height ratio, or body mass index) is the strongest correlate of components of the metabolic syndrome (ie, glucose and lipid concentrations and blood pressure) in the elderly.

Design: The Hoorn Study is a population-based cohort study in older Dutch men and women. Cross-sectional data were analyzed. Age-adjusted Pearson correlations of anthropometric measures with components of the metabolic syndrome were calculated in 826 subjects (389 men, 437 women) aged 56–83 y. Analyses were performed with adjustment for age and stratification for sex and age (<65 or 65 y).

Results: No single anthropometric measure was consistently correlated more strongly with components of the metabolic syndrome than were the other measures in either men or women. The associations were generally stronger in younger subjects than in older subjects and in women than in men. For example, the correlation between sagittal abdominal diameter and postload glucose was 0.35 (P < 0.001) in younger and 0.14 (P = 0.051) in older men, and the correlation between waist circumference and postload glucose was 0.33 (P < 0.001) in older women and 0.14 (P = 0.062) in older men.

Conclusion: The use of sagittal abdominal diameter has no advantages over simpler and more commonly used anthropometric measures such as the waist circumference in older men and women.

Key Words: Sagittal abdominal diameter • waist circumference • hip circumference • waist-to-hip ratio • waist-to-height ratio • body mass index • fat distribution • metabolic syndrome • elderly